Method and means for therapeutic application of high-frequency current



March 3, 1936., F, Q WAPPLER 2,32,859

METHOD AND MEANS FOR THERAPEUTIC APPLICATION OF HIGH FREQUENCY CURRENT Filed March 30, 1932 2 Sheets-Sheet l INVENTOR ATTOR March 3, 1936. F. c, \NAPPLER 2,@32,85

METHOD AND MEANS FOR THERAPEUTIC APPLICATION OF HIGH FREQUENCY CURRENT Filed March 30, 1932 2 Sheets-Sheet 2 Patented Mar. 3, 1936 UNITED STATES PATENT OFFICE METHOD AND MEANS FOR THERAPEUTIC APPLICATION OF HIGH-FREQUEN CY CUR- RENT 5 Claims.

My present invention relates generally to the surgical or therapeutic arts, and has particular reference to an improved method and means for applying high-frequency current to the human body.

It is a general object of my invention to provide a procedure and a means for passing high-frequency current through portions of the human body under conditions which are simpler and less diflicult than those usually encountered heretofore and devoid of many of the dangerous and precarious features of the art as heretofore practiced.

From one aspect, my invention relates to nonsurgical diathermy, i. e., to a method and means for utilizing a passage of high-frequency current for the primary purpose of inducing the generation of warmth or heat in the body at particular portions thereof, unaccompanied by any cutting, burning, or similar modification of tissue. From another aspect, my invention relates to diathermy of a semi-surgical character whereby my present invention is adapted to be employed for the mild surgical purpose of effecting superficial desiccation of tissue.

In the practice of non-surgical diathermy, it has been customary to apply a conductive electrode to the portion of the body to be treated, the electrode usually being in the form of a sheet, and composed of conducting material such as metal foil. In the employment of such electrodes, great care has always been necessary to establish a firm contact with the body and to avoid minute air gaps between the electrode and the body. In applying electrodes of this character to irregular contours, difficulties have frequently been encountered which have never, to my knowledge, been successfully obviated. For example, in applying electrodes of this metallic character to hairy portions of the body, it has been almost impossible to establish a firm contact. Frequently, if not regularly, the electrodes have been wetted, usually with a soapy solution, to facilitate the establishment of firm contact. Where the electrodes are kept in position for a considerable period of time, it has usually been necessary to rewet them from time to time. Even with this precautionary procedure, it has been notoriously diflicult to maintain firm contact, especially where movements of the body cause the electrodes to slip or slide or similarly alter their position.

The establishment of a firm contact, where conductive electrodes of the customary character have been employed, is essential for the reason that concentration of the current, due to uneven contact, causes burns which are all too frequently of a severe character. In fact, special care must always be taken in removing the electrodes to avoid burning at the point or points or edge of the electrode which is last to break contact with 5 the body.

In' accordance with my present invention, I am enabled to establish satisfactory and safe contact with even the most irregularly contoured portions of the body, and also with hairy portions or the 10 like, and this desirable object is achieved without the necessity for any special precautions or wetting or soaping and with no danger or likelihood of causing burns.

I have found that a high-frequency current, if 15 properly generated and sustained, can be caused to pass through the human body for non-surgical and semi-surgical diathermic purposes, where the electrode has an outer or exterior surface of nonconductive or dielectric material. further, that remarkably satisfactory results are achieved where the electrode is almost totally devoid of solid conductive material such as metal and where the current is conducted to the area of application by means of a conductive fluid. 25

Briefly, my invention resides, from one aspect, in an electrode consisting of a hollow applicator or contact-making portion, the applicator being of dielectric material, a mass of conductive fluid in the applicator, and a means for establishing a 30 direct electrical connection with such fluid.

In one embodiment of my invention, the applicator is of an elongated character and substantially rigid, being composed, for example, of glass or the like. adaptable for insertion into interior cavities of the body.

In another, and preferred, embodiment of the' invention, the applicator is of a flexible, baglike character, being composed of flexible dielectric material such as rubber or the like. An electrode of this type is of peculiar effectiveness inestablishing contact with such portions of the body as the armpits, the abdomen, the head, or other irregular or hairy portions. An electrode 45 composed of a distensible, bag-like applicator, adapted to contain a conductive fluid, is also of great utility in establishing firm contact with irregular internal cavities, especially where the cavities are accessible only through relatively con- 50 stricted passages.

Other features of my invention lie in an improved means for gaining valuable information as to the heat which is actually generated in the tissues, in a means for controllably varying the 55 I have found, 20;,

Such an applicator is peculiarly 7 instrumentality.

. Where the electrode is to be used for semisurgical purposessuch as desiccation, a preferred embodiment is constructed with the hollow applicator in the form of an operative tip arranged at the forward end of a suitable handle, the tip being filled with the conductive fluid and being provided with means, preferably extending rearwardly through the handle, forestablishing a direct electrical connection with the fluid.

I achieve the foregoing objects, and such other objects as may hereinafter appear or be pointed out, in the manner illustratively exemplified in the accompanying drawings, wherein- Figure 1 is a plan view of an electrode constructed in accordance with my present invention with a portion shown in cross-section;

Figure 2 is a view of a modified form of electrode, illustratively showing the manner in which it may be applied to an interior cavity;

Figure 3 is an enlarged, cross-sectional view similar to Figure 2 and showingcertain details of construction;

Figure 4 is a longitudinal, cross-sectional view of a modified type of electrode;

Figure 5 is a perspective view of an instrument or electrode designed for semi-surgical purposes.

Figure 6 is an enlarged, cross-sectional view through the operative end of the device of Figure 5; and v Figure 7 is a cross-sectional view taken sub stantially along the line 1-'| of Figure 6.

In Figure l, I have shown an applicator Ii] which is composed of flexible, dielectric material such as sheet rubber or the like. The applicator is substantially bag-like in characteristics and is adapted to accommodate a conductive fluid II which may, for example, be a liquid electrolyte such as salt water or the like. I have shown the applicator I 0 provided with a neck l2 in which a plug I3 is mounted in any convenient and liquidtight manner. .The plug I3 is of dielectric or insulating material, but is not necessarily flexible.

The plug I3 is provided with a bore in which an electricte'rminal I4 is snugly mounted. At its rear portion the terminal is provided with the fingers IE or with a'similar attachment arrangement, whereby a rod-like contact member I6 may 7 be readily inserted and removed, through the rear end of the bore, into firm and direct electrical contact with theterminal Id. The forward end of the terminal I4 is preferably disposed rearwardly of the forward edge of. the'plug' l3, some:

what inthe manner shown, so that it is virtually disposed ina recess I I. The'terminal erably metallicin character.-

In order to facilitate theattachment of the applicator to the body, I prefer to associate lugs l8 therewith, preferably in. the form of integral webs or fins arranged at spaced portions of the applicator l0. These lugs are adapted to receive and engage with straps or the-like-for securing the electrode in firm contact to the body portion through which'the high-frequency current is to bepassed.

The. applicator of Figure 1 is not necessarily refillable with fluid, and, in fact, it is preferably permanent in nature subsequent'to its 'manufacture. Where a liquid conductive fluid is used...

[4 is prefcare is taken during manufacture that all air and gases are absent from the interior of the applicator, the entire space being taken up by the liquid ll.

In employing the electrode of Figure 1, it is not necessary to employ any wetting or soaping procedures, nor need any particular precautions be taken in applying the same tohairy or irregular portions of the body. The entire electrode being flexible and deformable in nature, it is a comparatively simple matter to apply it to the portion to be treated and to hold it in firm contact with this portion by means of straps or the like which engage the fins or lugs l8 or similar lugs arranged at convenient points. When secured in place, the electrode adjusts and conforms itself readily to the particular contours involved by virtue of its inherent deformable character. Contact is then established between the human body and one terminal of one source of suitable high-frequency current; and a similar electrical connection is then made between the other terminal of the current source and the connector l6. When the latter is then inserted into contact with the terminal M, the circuit is closed, and the high-frequency current is conducted through the fluid l I into a virtually direct contact with the area of the body which is to receive the current. The contact is, of course, not strictly direct because a wall of dielectric material separates the body from the fluid II; but if the high-frequency oscillations are properly generated and sustained, the current will pass in the contemplated manner and will induce the desired warmth in the body contacted by the electrode.

It is to be noted that there is no danger of any sparking or burning. Whether the body portion be irregular or hairy, or whether the applicator is dry or wet, or whether it is applied or removed without any special precautions, is immaterial.

In Figures 2 and 3, I have shown a similar construction in which means are provided for varying the amount of fiuid in the applicator.

An applicator of distensible, dielectric material such as stretchable sheet rubber or the like, is secured at its rear end 2| in fluid-tight manner with a connector 22 shown in detail in Figure 3. One portion 23 of the connector constitutes a plug similar to the plug l3 of Figure 1. The central portion of the member 22 is adapted to accommodate an electric terminal 24 having an attachment portion 25 adapted to receive the contact 26. The terminal 24 is suitably shaped to arrange its forward tip 21 in direct contact with the fluid 28, and the tip 21 is preferably arranged in a recess 29.

The portion of the member 22 serves as a plug for a reservoir member 3| which may, for example, be in the form of a rubberbulb or the like. A bore 32 extends through the member 22 to establish communication between the interior of the applicator 20 and the interior of the reservoir 3|. In the arrangement shown, the terminal 24 is provided with a bore through the portion which lies in the bore 32, so that the passage of fluid between the applicator 20 and the reservoir 3| is not impeded.

In the bore 32 is a valve member 33 adapted to be adjusted to open or seal the bore communication 32.

One manner" of using the electrode is illustrated, more or less diagrammatically, in Figure 2. The fluid is caused to flow into the reservoir 3|, and the petcock 33 is closed. I This deflates the applicator 20, which may then be inserted into the illustrative interior body cavity 34. The petcock 33 is then opened, and the reservoir 3| is manipulated as by squeezing to force the fluid into the applicator 20, thereby distending the latter to any desired degree. For example, the applicator 2B of Figure 2, when distended by the fluid, will adjust itself automatically to the irregular contours of the walls of the cavity 34.' When the applicator has been distended to the proper or desired amount, the petcock 33 is again closed, and the electrode is then ready for use in the same manner as the electrode of Figure 1, except that it has been feasibly and effectively applied to the walls of an interior body cavity. It may be noted that a firm contact with such walls has heretofore been utterly unfeasible, if not impossible, for non-surgical diathermic purposes by the methods or instruments of customary practice.

Obviously, the device of Figures 2 and 3 is not necessarily limited to employment to interior cavities or portions of the body. The variable extensibility of the applicator, and the means for. controlling the amount of fluid in it, are features which may be of equal value and utility in connection with the establishment of sat-- isfactory electrical contact with other portions of the body, for example, under the armpits, or under the back of a patient lying on his back.

In Figure 4, I have illustrated a form of electrode in which the applicator 35 is of rigid material such as glass or similar dielectric materials cator. Connection is established'in the conven-' tional manner with the rear portion 42 of the terminal 39.

The applicator 35 has been illustrativelyshown in elongated form, and is designed primarily for insertion into body cavities. The establishment of suitable electrical connections is accomplished as hereinbefore described in connection with Figure 1, and the walls contacted by the applicator 35 are subjected to the diathermic treatment which results from the passage of high-frequency current.

In the methods heretofore employed for attempting to pass high-frequency current through the walls of interior cavities, applicators of metallic or conductive material have sometimes been employed. Not only have these applicators been subjected to the same dangers and difficulties hereinbefore illustratively specified in connection with similar metallic electrodes applied to the exterior of the body, but an accurate knowledge and constant control of the amount of heat actually generated by the passage of the current has never been feasibly capable of accomplishment. To insert a thermometer into a metallic applicator which establishes a direct electrical connection with the cavity wall to be treated serves merely to measure the heat of the airin the applicator, but this is grossly inadequate to afford even an approximate idea of the heat actually generated in the tissue. With my present electrode, the employment of a liquid conductive fluid affords the convenient opportunity to obtain more accurate information as to the actual heat generusually a good conductor of heat. As a result, the employment of a thermometer 43 immersed in the conductive electrolyte 4| affords a simple and expedient method of gaining information as to the amount of heat actually generated by the passage of high-frequency current through-the areas contacted by the applicator 35.

In all of the embodiments of my present invention, including thatof Figure 4 and the subsequent embodiment presently to be described, it is to be borne in mind that the conductive fluid, which is preferably, though not necessarily, liquid,

does not serve as a mere transmitter of heat to the areas contacted by the applicator, but serves as a conductor of the electric current itself. The walls of the applicator in each case serve, virtually, as the dielectric of an electrical condenser through which the high-frequency current passes by virtue of its characteristics.

In Figures 5-7, I have illustrated a modified construction which shows the manner in which my present invention may be employed for semisurgical purposes such as superficial desiccation. The applicator corresponding to that of the previous embodiments is composed of an operative, hollow tip 45, preferably of a dielectric material such asglass, mounted upon the forward end of a handle 46. The handle is preferably constructed with an interior conductive member 41 which'terminates at its forward end in the split jaws 48. These jaws are adapted to accommodate a rearwardly extending,xelectric terminal rod 49 which is mounted in the insulating head 50 which carries the tip 45, and which'is provided at its forward end with the contact portion 5| arranged in the interior of the tip 45, and hence in direct electrical connection with the fluid contained in the tip 45. A threaded connector member 52 is adapted to engage with corresponding threads on the handle 46 so that the tip, and the rod 49, may be withdrawn from the handle for possible replacement by a different type of, or differently configured, applicator tip. When the operative forward. end of the device is screwed onto the handle 46, the beveled interior surfaces of the member 52 have a wedging action upon the jaws 48 to establish a firm grip and contact between these jaws and the rod 49. At the rear end of the handle a terminal 52 may be provided to facilitate connection with the source of highfrequency current.

The tip is preferably filled with an absorbent carrying medium 53, such as cotton or the like, which facilitates the permanent accommodation in the tip of the conductive fluid such as a liquid electrolyte. In using the instrument of Figures 5-7, an electrical connection is established, as hereinbefore described, between one terminal of the high-frequency source and the body to be treated. The other terminal of the high-frequency source is connected at 52, whereby the conductive fluid in the tip 45 is brought into direct electrical connection with the high-frequency current. When the handle 46 is wielded so as to apply the tip 45 to a selected portion of the body, usually for the purpose of removing skin blemishes or the like, the circuit is closed by the passage of the high-frequency current through the dielectric material of the tip 45. Since this current is more concentrated than that which passes through the relatively more expansive areas of the applicators hereinbefore described, a semi-surgical diathermic effect is produced which results in superficial desiccation. I have ated inthe tissue, since the liquid electrolyte is:

found, however,'that the effect is not one of buming or searing, as mightbe the case where a con- 7 ductive tip is applied directly to the body, but is V of a peculiarly'safe and harmless character which accomplishes the desired results by the mere pase sage of the current and without any hot sparking or burning;

and enclosed portion, of the applicatoryit will beunderstood that under certain circumstances different arrangements might be feasibly provided for establishing the desired electrical connection with the conductive fluid. 'For example, a flexible wire or group of wires might be caused to extend into immersed relation with the fluid in any of the applicators herein described. Similarly, the material of the applicator need not necessarily be so soft and flexible as to be distensible; nor need it necessarily be as hard and as rigidas glass. 1 Various dielectric materials may be employed to meet difieringreguirements;

- 'It will be obvious that changes in the details herein described-and illustrated for the purpose of explaining the nature of my invention may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is therefore intended that these details be interpreted as illustrative, and not in a limiting sense. 1

Having thus described my'invention and illustrated its use, what I claim as new and desire to secure by Letters Patent is-- 1. A high-frequency electrode comprising a' freely distensible bag-like applicator composed of stretchable dielectric sheet material, a source of. high-frequency current, an electric terminal extending fromon'e terminal of said current source into said'applicator so as to establish a direct electrical contact with fluid in said ap-,

high-frequency current, an electric terminal extending from one'terminal of said current source into said applicator so as to. establish a direct electrical contact with fluid in said applicator,

and means carried by the applicator for feeding varying amounts of fluid into it to eifectdesired distentions thereof, said means comprising, 'a' reservoir of fluid supply, a conduit between said reservoir and the applicator, and means for selectively opening or closing said conduit.

3. The herein-described method of passing high-frequency current through the wall of an interior body cavity, which consists in establishing an electrical connection between the body and one terminal of a source of high-frequency current, inserting into said cavity a collapsed yet distensible dielectric container, thereupon feeding a conductive fluid into said container so as to distend the latter and force it into contact with the cavity wall, and flnally establishing an electrical connection between the other terminal of said current source and the conductive fluid within said container.

4. A high-frequency electrode comprising .a freely distensible, bag-like applicator composed of stretchable, dielectric, sheet material, a conductive fluid therein, a source of high-frequency current, an electric terminal extending from one freely distensible,'bag-like applicator composed of stretchable, dielectric, sheet material, a reser-.

voir of variable capacity carried by said applicator, whereby filling the reservoir with conductive fluid and thenreducing its capacity will feed a predetermined quantity of said fluid into the applicator to distend the latter, a. source of highfrequency current, and an electric terminal ex-' tending into the applicator and adapted to make direct electrical connection between one. terminal of said current source and the fluid in said ap-' plicator."

FREDERICK CHARLES WAPPLER. 

